| NPI | 1427549674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN D14018) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WI 1001853) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2024-01-30 |